A paramedic's chance arrives when 'time is of the essence'

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When seconds determine the difference between life and death, Austin-Travis County Emergency Medical Services paramedics respond with urgency in providing pre-hospital care to patients, while keeping cool, level heads.

As trained medical-care professionals, EMS paramedics serve as an initial emergency response when time is of the essence and when emergency-room care is not readily available. They tread on to ensure public health and safety, sometimes working through whole days without rest.

“We are paid for availability ... We have to do so many different things,” Tiger said. “We are there with the training. If we don’t help [the patients], nobody is going to help them. We have to separate ourselves emotionally from it long enough to do our job.”

Within five minutes of beginning their first 12-hour shift together at 7 p.m., Tiger and Moden were dispatched to the Frank Erwin Center, where a man had passed out during a graduation ceremony.

The center’s in-house EMS unit provided initial care for the man, and Tiger and Moden continued it upon their arrival by checking his vital signs, including blood sugar, blood pressure and blood-cell carbon dioxide levels. While transporting the man to the hospital, Tiger drove the ambulance while Moden remained with the patient in the back, keeping track of his vitals and comforting him during the journey.

After transferring the man to the hospital’s ER, Tiger and Moden walked back to the ambulance with a stretcher and paperwork in hand as the man waved goodbye.

“We are going to show [our patients] that we care. We are going to go out of our way to do whatever we can to help them out,” Moden said. “We are not there just doing a job — we care about them.”

Austin-Travis County EMS has approximately 400 paramedics spread more than 38 available ambulances dispatched from 20 stations. According to its 2008 annual report, Austin-Travis County EMS dispatched units to 116,897 medical emergencies, special events and rescue and tactical operations.

On average, ambulances were dispatched within 65 seconds of a call, and the time elapsed between the moment an incident occurs and the point when a patient arrives at the hospital was, on average, 36 minutes and 13 seconds.

“You are never really off duty. You are just not at work,” said Millie Zapata, the commander of field operations, who checks in with paramedics across the county during her 24-hour shift. “Being a paramedic is not for everybody. It’s not a controlled environment — you never know what you are going to get into.”

Around 10:30 p.m., a call was made from Shiner’s Saloon downtown, where a woman had fallen over a ledge and cut her head. Tiger and Moden quickly jumped into the ambulance, sounded their sirens and were inside the crowded bar attending to the woman within minutes.

In the hysteria of the last second of the UT game, Tiger and Moden led the woman to the ambulance, where they cleaned her head wound and assessed her other injuries, including a potentially broken wrist, which was swelling and showed signs of internal bleeding.

Tiger and Moden said they often face the obstacle of bystanders who can inadvertently hinder patient care. They said the biggest danger they face are high-speed vehicles that pass by only feet away from them as they respond to highway accidents.

Tiger said he has encountered a number of deaths and the variety of emotions caused by them while on the job. But Tiger said that in any situation, paramedics persevere, such as during an incident last month in which a 2-year-old boy showed no pulse for up to 14 minutes after drowning. Tiger and assisting paramedics were able to the revive the boy, who lived, even though his heart had stopped six times.

Between calls, Tiger and Moden wait at the station, filling out paperwork from calls, watching TV and talking with each other.

Three sheetless bunk beds are housed in the station for quick naps, Moden said. She said the most stressful aspect of the job is not necessarily the type of calls received, but rather the pressure that it places on her personal life. After working days on end, she returns home to her fiance, but often her personal time is disrupted by the need to sleep for another day on the job.

Tiger said TV shows have a tendency to romanticize the details of the job and typically pack a career’s worth of events into just 30 minutes. He said EMS units respond to everything from minor events such as a person stubbing their toe to emergency situations with multiple lives at stake. The stress of the job has made him wary of his children’s safety, Tiger said, resulting in his overprotectiveness.

“It’s a tough world out there. A lot of people are insulated from the emergencies that happen,” Tiger said. “You are thankful for the ones you can save, pray for the ones you can’t and try to learn something from everybody — every one of them.”